New Methadone Restriction Question

[PainsMyName]

As of the 1st of january pain doctors will not be able to perscribe methadone 40mg wafers anymore.

http://www.deadiversion.usdoj.gov/pu...e_advisory.htm (http://www.deadiversion.usdoj.gov/pu...e_advisory.htm)

Hi, I am currently perscribed to 4 - 40mg methadone wafers a day which is 160mg's a day. I get this medication for treatment of severe chronic pain. This has been a miracle medication for me and has given me my life back.

I have a question and did some reasearch and couldnt find an answer to. I know 40's are being taken off the market. The 10's will still be available. Will I be able to get 12 - 10mg methadone's a day, which would be a perscription for 360 a month or is there a law or somethingsaying you can only get so many a month?

Ive been trying to find presctiption limitations as far as how many of a medication a doctor can perscribe a month or is it unlimited and the doctor can write it for whatever as long as its justified?

Please Help, Shawn

[Wise Young]

As of the 1st of january pain doctors will not be able to perscribe methadone 40mg wafers anymore.

http://www.deadiversion.usdoj.gov/pu...e_advisory.htm (http://www.deadiversion.usdoj.gov/pu...e_advisory.htm)

Hi, I am currently perscribed to 4 - 40mg methadone wafers a day which is 160mg's a day. I get this medication for treatment of severe chronic pain. This has been a miracle medication for me and has given me my life back.

I have a question and did some reasearch and couldnt find an answer to. I know 40's are being taken off the market. The 10's will still be available. Will I be able to get 12 - 10mg methadone's a day, which would be a perscription for 360 a month or is there a law or somethingsaying you can only get so many a month?

Ive been trying to find presctiption limitations as far as how many of a medication a doctor can perscribe a month or is it unlimited and the doctor can write it for whatever as long as its justified?

Please Help, Shawn

I am sorry but I don't know the answer to your question. Wise.

[Lee555]

I expect that you would still be able to get the 10 mg dose by the way it reads. I imagine the reason they took the 40 off the market and restricted it is because of the potential for overdose. See the one sentence in bold type. Adverse events they say. You would probably have to talk with your doctor about it, and the pharmacy which would supply you. They might have to dole it out in two batches to you. Truely an inconvenience.

As of January 1, 2008, manufacturers of methadone hydrochloride tablets 40 mg (dispersible) have voluntarily agreed to restrict distribution of this formulation to only those facilities authorized for detoxification and maintenance treatment of opioid addiction, and hospitals. Manufacturers will instruct their wholesale distributors to discontinue supplying this formulation to any facility not meeting the above criteria.
Methadone is a long-lasting opioid medication used in the treatment of pain and narcotic addiction. The 5mg and 10 mg formulations indicated for the treatment of pain will continue to be available to all authorized registrants, including retail pharmacies. The 40 mg methadone formulation is indicated for the detoxification and maintenance treatment of opioid addiction. The 40 mg strength is not FDA approved for use in the management of pain. Thus, the distribution and availability of the 40 mg formulation will be limited to registrants in only those settings using the 40 mg formulation for the appropriate indication.
The DEA and pharmaceutical industry agree that the reported increase in methadone-related adverse events merits action and further agree to a united effort to assure that methadone is properly distributed, consistent with its approved uses. Industry and the federal entities involved commit to monitor the progress of this initiative.

[metronycguy]

it is common to get 120 a month of many pain meds fpr pain patients.
hopefully it is just the worry of overdose,

[PainsMyName]

OK, so the doctor will be able to give me 12 - 10mg methadone a day? hats 360 pills a month, that seems like alot but its actually 40mg less then my normal a day. Just 360 seems like alot and I just wanted to know if there are restrictions to writing perscriptions for that many pills.

Thanx,
Shawn

[metronycguy]

i hope not, bu ti guess you willf ind out within the month

[Zeph]

A doctor can write for as many pills as you need

[PainsMyName]

A doctor can write for as many pills as you need

Hey Zeph, how do you know this? Do you have any proof I could take to me doctor?

Merry Christmas,
Shawn

[JonnyC]

What's wafers?

Thought about taking the oral liquid? I used to take it and its good pain killing material.

You in the US or UK?

[PainsMyName]

UPDATE!!!!

Well I went in to the doctor and almost cried! I have been on methadone 40mg 4x daily for 2+ years now. That is equilivlant to 160mg a day. This was a perfect dose for me! It really helped my pain an allowed me to manage my pain with my life. I was able to finally start working again thanx to this medication.
Well the 40mg methadone wafers were taken off the market on the 1st but the 5 and 10mg tablets were still avaiable for pain management. So I figured that I would get 12-16 methadone 10mg tablets a day which would be the same dose I was taking with the methadone 40mg wafers.
WRONG! At first the doctor was only going to give me 4 methadone 10mg a day! I flipped out, he would be cutting 120mg a day in one MONTH! Methadone is a drug that needs to be tapered slowly. I eventually got him to give me 8 methadone 10mg tablets a day which is still HALF of what I have been getting for 2+ years.
I am in so so so much pain that I can't even work. I lost my job and am now bed/coach ridden again. WHAT DO I DO? I am thinking about maybe looking for a new doctor. Any advice would be helpful at this moment. I would have posted what happened earlier but I've been in so much pain I dont even want to go on the internet.

Shawn

[David Berg]

I am so sorry to hear about this Shawn. I sincerely hope you can find a solution. I can't stand it when politicians and bureaucrats dabble at practicing medicine like this, pressuring and restricting doctors. I have to wonder what in the heck your doctor was thinking to even consider dropping you to 1/4 of the dose you'd been taking all along, that's just insane. Feel free to rant here whenever you need.

Perhaps at the very least you can look into other meds you can take along with the methadone? If you read here, it's pretty common to have to use more than one med to fight this level of pain.

[rfbdorf]

Shawn, what's the source of your pain? Are you SCI? There's nothing in your profile to tell.
- Richard

[cljanney]

I'd recommend a new Dr. You should at the very least be tapered down adequately.

Getting off methadone was one of the hardest things I've ever done,
besides hiking to Everest base camp w/one functioning lung.

Good luck.

[Fastasaturtle]

i went to a pain mngment clinic, he basicly gave me what i asked for, however; i had to get him to write and fax a permission slip to my regular dr...(lol) saying "here's what you should give him...to cover my regular md's rear.

[Lupus Sucks]

Oh Shawn this is a criminal act in my opinion. I take methadone and am on 60mgs a day and also I get 4-30mgs Roxicodone tabs for breakthru a day..so I am getting 180 methadone pills and 120 Roxi pills. I would seriously find another pain clinic or get to a methadone clinic and get back up to your dose. I know the clinic is crappy but at least you would get your dose everyday (but having to go in everyday sucks). Eventually you would be able to get takehomes from the clinic but it takes a while. How important is it for you to work, not be bed ridden etc? Me, I would do what it takes but thats me. I sure hope your able to find another doctor. If not and your wanting to go to a methadone clinic, then I can help you find one in your state. Just email me...and put CC forums in the subject.

[mariegraunke]

you need to call a pain clinic or a methadone clinic if you give me the city you are by i can get a clinic and they can put on your normal dose without hesitation-you would need proof of taking such a dose though-instead of dealing with the doc-it could cost you 55-80 bucks a week for a clinic- but they are good- i go to a private methadone clinic it is very nice, clean, and i can increase my dose once a week:agog: -i didn't even know docs can perscribe it to a pharmacy-i am still taking the 40mg waffers in illinois-a doc can perscribe as many pills as he wants it is up to the pharmacy if it gives off a red flag to the DEA-they may suspect-i know from prev pain pill refills-

[brnton2whls]

Hi,
I just want to say i'm a c/3-4 incomplete spinalcord injury and have been on methadone for about 10 years, it also has been a life saver for me to.
My doctor gives me a 18 10mg tablets a day.I believe it just depends on your doctor my doctor dose'nt have a problem with this.

[PainsMyName]

Well I called the office and managed to get in to see the doc again on monday the 28th. I went on the 5th this month so the doctor is seeing me early. I also have another appointment set up with a new doctor on Feb 8th. I am going to take in my perscription histroy, my MRI files, and doctor notes from past doctors. I have a feeling that my doctor i see on monday will be once again lowering my dose! It happened to my friend so i figure it will happen to me. I will probally get lowered another 2 pills a day so I will be on 60mg a methadone a day, when little over a month ago i was on 160mgs a day.

I am going to tell this new doctor how much pain I have been in. That I lost my job because I couldnt perform at work because my pain was not managed right this past month. For so long my life felt somewhat normal meaning I started to enjoy the great things about life because my pain was managed so well with the dose I was on. I eventaully found a job and started working again, i am doing family activities, and even going out and about with friends alot more and enjoying life. Since my drop in dose I think I left the house once. I have no appetite, lost my job, pretty much bed/couch ridden, grumpy, and not active at all anymore.

My life has done a complete turn around for the worse. I feel better today hence the reason I am writing back because after I called to make an appointment to see my doc again and they let me come in early, I took 80mgs this morning which is my normal dose and will probally take another 40mg tonight. I think I could get by on 120mgs a day and be allright, but for some reason my doctor wants to get all his methadone patients down to 60mg no matter what dose they were on before.

Hopefully this new doctor can keep me managed at 120-160mgs a day and I can get my life back. I wont be able to get my job back because I left on bad terms, My boss doesnt fully understand what kind of pain I deal with everyday and the whole situation.

Any advice on what I should tell this new doctor would be helpful.

[PainsMyName]

Well i went to see my regular doctor today and once again I was dropped down to 6 methadone 10s a day. To think i was on 160mgs a day for 2+ years and get dropped down to 60mgs a day in less then 45days is insane. If someone told me that would happen I would of never believed them. I go see this new doctor in 11 days. I am just going to explain to this new doctor what my life has been since the cruel drop in meds.

When I was on 160mgs a day, everything was all good and I started slowly but surely getting my life back. My pain was managed greatly. I was actually able to go out and get a job and work like a normal human. I was able to live a somewhat normal lifestyle by being able to go to the movies, or hang out with friends and family and due things that normal people would do. I would still be in pain but it was managed perfectly to the point where I could do those things.

Since the drop I have lost my job because I couldnt perform up to par because of pain. I am a very iritable person. My family cant even stand me. Because when I am in great pain I am a monster. I am rude, not nice, almost unbearable. I left the house all but 2 times this month. I stayed home when family went out to eat or to the movies because of my pain. I was even able to take small walks before and now I dont even want to get up in the morning or get off the couch. The pain is so bad, it shoots down my left buttox and down my left leg. Feels like someone actually took a sharp knife and is stabbing my butt and cutting it all the way down to my leg.

I hope this new doctor understands that my pain was managed really good at a dose from 120-160mg of methadone a day, and that I could live a somewhat normal lifestyle at that dose. Wish me luck and I will keep you all informed of what happens on the 8th.

I want to personally thank everyone here who has given me advice and helped me threw this process. So... THANK YOU

Shawn

[David Berg]

What in the world does this doctor say he's trying to do? How does he respond when you tell him how this has affected you after having been successfully managed for so long?

[PainsMyName]

What in the world does this doctor say he's trying to do? How does he respond when you tell him how this has affected you after having been successfully managed for so long?

To be honest I am so fed up its not even funny. This time I went in to the doctor and saw a completly new doctor. Someone I never seen before. I asked to see my norm doc but couldnt. I couldnt leave with any meds either. SO i had to do a complety physical with this doctor and explain my whole story of what happened and the past 4 years of my life and so on.

I also explained to the doctor what I have been going threw this past moth and he jus tlistened the whole time and didnt say much if anything at all. Lets see he said "oh ok" "i see" 'hmmmm' yead thats about it.

Then he looked at my file and wrote out my script and finally said well this is what Im giving ya I am bumping you down to 6 methadone 10s a day. He didnt even give me the chance to discuss this, and that was it. Out he walked, he went and copied the script and I got the script handed to me from some other worker.

Since going to this clinic I saw 6 new doctors each time having to get a physical exam and tell my whole story over. Im fed up.

I do see a new doctor on Friday and I cant wait because I have heard good things about this new doctor. There is no way I am going back to that bullcrap of a clinic I have been going to.

[David Berg]

I wish you the best of luck with your new doc, PMN. Sometimes it takes a disgusting amount of digging to find someone with the integrity and guts to actually help, but there are some real heros out there.

[rollin64]

if i was to go thru a methadone clinic.......is that a PAIN?

i was thinking of trying methadone. pain dr's here suck. after 7 yrs of hurting i finally got lucky an found a doc to perscribe me oxy but he's 80+ yrs old so ya know how long this'll last, ha.

[arndog]

PMN - I , too, am shocked at the behavior of that physician group. I am so sorry for you.

I don't understand if you were getting along well on your daily 160mg, functioning in the working world, happy, and engaged in life, why anyone would change your dose.

I was on Methadone and getting off it was one of the most horrible, difficult things I have ever done, and I have climbed El Cap in Yosemite 6 times as well as alpine climbed to 23,000 ft in Peru. Nothing was as difficult as getting off Methadone.

I have struggled with post SCI neuropathic and spine pain for 6 years and my philosophy has changed in regards to narcs which I have had a love/hate relationship.

I now believe that it is worth taking what you need to get your life back. The goal isn't to get off them, it is not possible .

I hope you find a better doctor who treats you like a person.

jon